French A&E crisis as staff take off for the summer

French hospital casualty units are facing a staffing and bed crisis this summer, indicating widening cracks in a health service recently judged the finest in the world.

French hospital casualty units are facing a staffing and bed crisis this summer, indicating widening cracks in a health service recently judged the finest in the world.

The accident and emergency unit of a large hospital in Marseilles barred ambulance admissions until further notice last week, and casualty departments at hospitals in other big cities face similar strains, caused by budget cuts and staff shortages as well as the absence of GPs on holiday in August.

The head of the casualty unit in Marseilles, which serves the poor, northern districts of the city, blames a growing tendency to dump elderly people in hospital during the summer months.

"Every year it's the same thing," said Professor Yves Frances, head the Marseilles Nord hospital's emergency department. "Heartless people treat hospitals like old people's homes. They abandon old people in our wards."

Last week, Professor Frances caused a stir by announcing that his unit had closed its doors to sick people brought by ambulance. Only casualties and people who came to the hospital by their own means would continue to be treated, he said.

The hospital had been left with no choice, he said, because nurses kept taking sick leave. With holidays and posts unfilled, the professor's team of 50 nurses had dwindled to fewer than 25.

Beyond that, there were no beds available in the main wards to take people admitted through casualty. Hospitals in Strasbourg report similar crises. There, the number of patients treated in hospital casualty units has increased six-fold in 10 years, peaking in the summer.

Militant and disaffected French GPs were taking longer holidays without arranging cover, officials said. Their patients, therefore, are diverted into casualty units.

Increasingly, the poor and unemployed, who are not always entitled to reimbursements for GP visits, costing €20 (£13) a time, turn to casualty units for free treatment for minor ailments.

In some cities, though not yet in Marseilles, the problem has been compounded by the shortening of the official working week to 35 hours, which has reduced the availability of nursing and auxiliary staff.

Olivier Martinet, head of the casualty unit at the Hautepierre hospital in Strasbourg, said: "We are getting more and more young people who have no GP and want rapid treatment, but also more and more old people."

The World Health Organisation has named the French health service as the best in the world for the past two years.

The country has nine hospital beds for every 1,000 people, compared with 4.9 in the UK. France also spends 9.9 per cent of its GDP on health care, compared with 6.8 per cent in Britain. The average for EU countries is 8.6 per cent.

In recent years, however, the strains have begun to show. GPs, junior doctors and nurses have been protesting that their earnings have been kept down to prevent the national health budget from soaring.